Abstract
A 53-year-old female suddenly developed petechiae on her thighs on June 22, 1979. She visited a doctor who made a diagnosis of severe aplastic anemia by hematological examination, and was reffered to the Nagoya 1 st Red Cross Hospital for bone marrow transplantation on July 16. On admission examination revealed a severe pancytopenia and hypocellular bone marrow: RBC was 2.11×106/μl, reticulocyte 0.4%, WBC 2,300/μl with 2% neutrophils and platelets 2,100/μl in peripheral blood and hematopoietic cells 3.6% in the bone marrow. Prior to transplantation, she was conditioned with intravenous cyclophosphamide, 2,500mg a day, for four days. On July 24, she received a bone marrow aspirate (8.4×109 nucleated cells) from an HLA-identical sibling (50-year-old female). She was treated periodically with intravenous methotorexate for prevention of GVHD. About two weeks later, her hematological findings suggested a successful engraftment. But because of delayed recovery of hematopoietic cells, methotrexate was changed to prednisolone on the 68 th day. Thereafter all hematopoietic elements increased rapidly without any sign of GVHD. At present she is completely healthy and hematologically normal: RBC was 3.73×106/μl, WBC 6,000/μl with 36% ncutrophils and platelets 5.1×105/μl in periperal blood on March 4, 1980.
